ABSTRACT
ObjectiveTo determine the characteristics， viral load and immunological status of HIV-infected persons and their spouses who became HIV-positive， and the reasons for HIV seroconversion in 55 HIV discordant couples in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunan Province. MethodsData on the 55 couples meeting the criteria of having a previously positive spouse were retrieved from the AIDS Integrated Prevention and Control Data Information System of the China Disease Control and Prevention Information System during 2015-2021. General socio-demographic information， age at diagnosis， exposure history， CD4+T lymphocyte count， and antiviral treatment were collected. Descriptive analysis and chi-square test were used to compare the distribution of pre-HIV-positive spouses and their HIV seroconverted spouses. ResultsA total of 55 spouses from HIV discordant couples had HIV seroconversion. Of them， 72.7% （40/55） of pre-HIV-positive spouses were husbands. The most recent CD4+T lymphocyte count in the pre-HIV-positive spouses was （328.31±246.27） cells·μL-1 at the time of diagnosis of their seroconverted spouses， of which 36.3% （20/55） had a CD4+T lymphocyte count of less than 200 cells·μL-1. Furthermore， of those pre-HIV-positive spouses with low CD4+T lymphocyte count， 45.0% （9/20） had an undetectable viral load， 15.0% （3/20） <400 copies·mL-1， and 25.0%（5/20） ≥400 copies·mL-1. Additionally， 16.4% （9/55） of the pre-HIV-positive spouses did not have a viral load test. The main reasons for HIV seroconversion among HIV-negative spouses in the discordant couples were poor condom use， poor compliance with antiviral therapy， and treatment discontinuation. ConclusionThe follow-up management of HIV discordant couples should be strengthened in Dehong Prefecture， especially the monitoring of viral load levels and immunological status of pre-HIV-positive spouses， to improve their compliance with antiviral therapy and reduce treatment discontinuation， which would effectively prevent and control HIV transmission between spouses.
ABSTRACT
Objective To analyze the mortality rate in index partners of HIV discordant couples in the context of antiretroviral therapy and related factors in Zhumadian,Henan province.Methods An open and prospective cohort survey was conducted annually during 2008-2014.Information about the index partners'demographic characteristics,CD4+T (CD4) cell counts,viral load,AIDS-related syndromes,date of therapy initiation,level of treatment institution,and outcome of death were collected.Life table was used to calculate survival rate,and Cox proportional hazards model was used to analyze the mortality related factors.Results Among 4 196 index partners receiving antiretroviral therapy between 2008 and 2014,350 were fatal,with the mortality rate of 1.88 per 100 person years (95％CI:1.86-1.90).The survival rates of these patients with the duration of follow-up from 1 to 7 years were 99.64％,97.70％,95.62％,93.54％,91.25％,86.86％ and 82.36％ respectively.Factors related to the survival of the index partners of HIV discordant couples were age ≥50 years (HR=3.48,95％CI:2.67-4.55),junior high school or above education level (HR=0.75,95％CI:0.56-1.00),baseline CD4 cell counts ＞350 cells per μl (HR=0.55,95％CI:0.42-0.72),baseline viral load ＞400 copies/ml (HR=1.71,95％CI:1.32-2.22) and initiating treatment prior to cohort entry (HR=0.65,95％ CI:0.41-1.05).Conclusions The mortality rate of index partners receiving antiretroviral therapy was relatively low,indicating a better effect of long-term treatment on patients' survival.It is necessary to further identify and control the key factors influencing the survival of patients receiving therapy,improve the timeliness and adherence of the treatment,keeping patients' immunity level.Meanwhile,much attention should be paid to the drug resistance due to long term treatment and treatment failure.
ABSTRACT
Objective To analyze the mortality rate in index partners of HIV discordant couples in the context of antiretroviral therapy and related factors in Zhumadian,Henan province.Methods An open and prospective cohort survey was conducted annually during 2008-2014.Information about the index partners'demographic characteristics,CD4+T (CD4) cell counts,viral load,AIDS-related syndromes,date of therapy initiation,level of treatment institution,and outcome of death were collected.Life table was used to calculate survival rate,and Cox proportional hazards model was used to analyze the mortality related factors.Results Among 4 196 index partners receiving antiretroviral therapy between 2008 and 2014,350 were fatal,with the mortality rate of 1.88 per 100 person years (95％CI:1.86-1.90).The survival rates of these patients with the duration of follow-up from 1 to 7 years were 99.64％,97.70％,95.62％,93.54％,91.25％,86.86％ and 82.36％ respectively.Factors related to the survival of the index partners of HIV discordant couples were age ≥50 years (HR=3.48,95％CI:2.67-4.55),junior high school or above education level (HR=0.75,95％CI:0.56-1.00),baseline CD4 cell counts ＞350 cells per μl (HR=0.55,95％CI:0.42-0.72),baseline viral load ＞400 copies/ml (HR=1.71,95％CI:1.32-2.22) and initiating treatment prior to cohort entry (HR=0.65,95％ CI:0.41-1.05).Conclusions The mortality rate of index partners receiving antiretroviral therapy was relatively low,indicating a better effect of long-term treatment on patients' survival.It is necessary to further identify and control the key factors influencing the survival of patients receiving therapy,improve the timeliness and adherence of the treatment,keeping patients' immunity level.Meanwhile,much attention should be paid to the drug resistance due to long term treatment and treatment failure.